Amanda Degnan Jackson

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

906654 Issued in MS

Practice address

919 Ferncliff CV Ste 1
Southaven, MS 38671-2402

Phone

(662) 205-5045

Fax

(844) 444-1263

NPI assigned

Apr 29, 2024

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• TMK Enterprises

  • Psychiatric/Mental Health Nurse Practitioner
  • Southaven, MS
  • NPI 1184251795

  Single Specialty

  Medicare reassignment NPD
• The Mental Day PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Southaven, MS
  • NPI 1013877612
  NPD Authorized official
• Heale Counseling, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Tupelo, MS
  • NPI 1699559740
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1714348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768176000000",
    "number": "1295581486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "919 FERNCLIFF CV STE 1",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386712402",
            "telephone_number": "662-205-5045",
            "fax_number": "844-444-1263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "919 FERNCLIFF CV STE 1",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386712402",
            "telephone_number": "662-205-5045",
            "fax_number": "844-444-1263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "AMANDA",
        "middle_name": "DEGNAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-29",
        "last_updated": "2026-01-12",
        "certification_date": "2026-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MS",
            "license": "906654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Koete Irvin
• Ismile Family Dentistry
• Renita Monae Isom, M.S. CCC-SLP
• Issues of Life, Inc.
• Ivyraine Women'S Clinic
• Annie Marie Jackson, LMSW
• Cassandra Lovette Jackson, COUNSELOR
• Holly Jackson, CRNA
• Leigh Jackson, MD
• Savannah Brooke Jackson, PHARMD

• Psychiatric/Mental Health Nurse Practitioner in Southaven, MS
• Providers in Southaven, MS by specialty
• Psychiatric/Mental Health Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.